The Total Teen program improved access to sexual and reproductive health and mental health services for at-risk adolescents across three clinic settings, with gender and sexual behavior scores significantly associated with service utilization.
Key Findings
Methods
The Total Teen program was implemented across three distinct healthcare settings and enrolled 451 adolescent and young adult participants over 12 weeks.
Participants were aged 12-25 years across school-based health clinics, a federally qualified health center, and an adolescent health clinic
The pilot study ran for 12 weeks
Sociodemographic data collected included age, race/ethnicity, gender, and insurance status
The program provided one-on-one time, confidential consultations, SRH and MH micro visits, and referrals
Results
Being male was significantly associated with lower rates of depression among participants receiving micro visits and referrals.
The association between being male and lower depression rates was statistically significant (P = .0003)
Mental health was assessed using the Patient Health Questionnaire (PHQ)-9 scale
Logistic regression models adjusted for age, gender, race, and site
This finding pertained specifically to the micro visits and referrals outcome category
Results
Being male was significantly associated with lower rates of generalized anxiety disorder among participants.
The association between being male and lower generalized anxiety disorder rates was statistically significant (P = .0099)
Anxiety was assessed using the Generalized Anxiety Disorder (GAD)-2 scale
This finding was identified within the micro visits and referrals analysis
Results were adjusted for age, gender, race, and site in logistic regression models
Results
Being male significantly predicted receipt of micro visits.
Male gender was a significant predictor of micro visit receipt (P = .0199)
Micro visits were used as a measure of access to care within the Total Teen program
Analysis used logistic regression models adjusted for age, gender, race, and site
Results
Higher sexual behavior scores were significantly associated with a greater likelihood of utilizing sexual and reproductive health micro visits.
The association between higher sexual behavior scores and SRH micro visit utilization was highly statistically significant (P < .0001)
Sexual health was evaluated based on CDC guidelines and additional evidence-based questions
This finding indicates that adolescents with riskier sexual behaviors were more likely to access SRH-specific micro visits
Statistical comparisons used descriptive statistics, Pearson Chi-square tests, and Kruskal-Wallis tests alongside logistic regression
Conclusions
The Total Teen program improved access to sexual and reproductive health and mental health services and referrals for at-risk adolescents.
Access was measured through one-on-one time, confidential consultations, SRH and MH micro visits, and referrals
The program operated across three different types of healthcare settings serving adolescents and young adults
Findings underscore the importance of integrating SRH and MH services into routine adolescent care
The study identified the need to involve health organizations and providers as key stakeholders in enhancing preventive healthcare access
What This Means
This research suggests that a clinic-based program called Total Teen can help teenagers and young adults (ages 12-25) access sexual and reproductive health and mental health services more easily. The program was tested over 12 weeks in three types of healthcare settings — school-based health clinics, a community health center, and a specialized adolescent health clinic — and enrolled 451 young people. It offered private, one-on-one consultations, brief specialized health visits (called 'micro visits'), and referrals to additional services.
The study found notable differences by gender and health behavior. Male participants were less likely to show signs of depression and anxiety, and were more likely to receive micro visits. Young people who reported higher-risk sexual behaviors were significantly more likely to use the sexual health micro visit services, suggesting the program successfully reached those who needed those services most. These findings point to the value of tailoring healthcare outreach by gender and risk profile.
This research suggests that embedding both sexual health and mental health services together into routine adolescent healthcare settings — rather than keeping them separate — can improve access for young people who might otherwise not receive these services. The authors emphasize that healthcare providers and organizations need to be actively involved as partners to make preventive care more accessible for adolescents, particularly those at higher risk.
Garney W, Han G, Esquivel C, Garcia K, Ajayi K, Wilson K. (2025). An Innovative Clinic-Based Intervention to Improve Adolescent Access to Sexual and Mental Health Services: The Total Teen Program.. Journal of primary care & community health. https://doi.org/10.1177/21501319251315307